MEDICARE: DR. DONALD B RUBIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N001871	NY

General Provider Information

NPI Number	:	1689750432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD B RUBIN DPM

Provider Business Mailing Address
First Line	:	10792 SKYLINE DR
Second Line	:
City	:	CORNING
State	:	NY
Zip	:	14830-3262
Country	:	US
Telephone Number	:	607-962-0176
Fax Number	:

Provider Business Practice Location Address
First Line	:	154 E 2ND ST
Second Line	:
City	:	CORNING
State	:	NY
Zip	:	14830-2802
Country	:	US
Telephone Number	:	607-936-6933
Fax Number	:	607-936-3619

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	10/10/2007

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